Treatment for Children’s Increasing Myopia

Treatment for Children’s Increasing Myopia

Myopia (nearsightedness) in children is often managed with spectacles or contact lenses. Once the need for glasses has passed, individuals frequently have refractive surgery like LASIK or PRK. In cases of progressive myopia, the child’s nearsightedness usually starts in early childhood and gets worse as they get older. Many patients and their families want to know why myopia worsens and whether it may be slowed down.

Myopia has a strong genetic component, therefore the likelihood that a kid may develop myopia increases if one or both parents are near-sighted. Children who spend more time outside are less likely to acquire myopia, according to some significant research. Although the precise cause is unknown, exposure to sunshine is regarded to provide potential health benefits. Numerous close-quarters tasks at a young age may be hazardous, according to other studies.

To reduce the rate of myopia development, numerous therapeutic methods have been investigated. Recent recommendations include:

Low dosages of atropine eye drops have been demonstrated in numerous trials to be able to halt the progression of myopia, albeit it is still unknown how this is accomplished. In addition to being used to treat amblyopia in children, atropine eye drops are dilating eye drops that are frequently used after eye surgery, ocular damage, or eye inflammation. The 1% atropine commercially accessible dose for these uses typically causes substantial pupillary dilating, light sensitivity, and obscured near vision. The focus of more recent research has been on administering atropine eye drops in lower concentrations to lessen the negative effects brought on by this medicine. When compared to greater dosages of atropine, the lower dose of 0.01% atropine has repeatedly been found to be more effective at slowing the rate of myopia development (i.e., less to no light sensitivity and blurred near vision). Previous research has indicated that quitting the higher (1%) dose of atropine can cause a rebound effect, which is a significant worsening or rise in myopia after the eye drop was stopped. However, this impact was found to be less pronounced after stopping the lower dose of atropine.

The use of atropine eye drops for this condition necessitates daily application for a minimum of one to two years. It takes a specialized pharmacy to create the eye drops because the atropine dosage is lower than usual.

Several clinical trials are now being conducted to examine the efficacy of low dosages of atropine in slowing the progression of myopia. Therefore, the atropine dosage that you can be advised to take ranges from 0.01% to 1%.

Multifocal contact lenses have also been investigated for their potential to slow the progression of myopia. To try to slow down the growth in myopia, many multifocal contact lens options may be administered. The first American myopia correction method to receive FDA approval was MiSight contact lenses in 2019. These daily disposable contacts must be fitted by an optometrist or ophthalmologist with specialized training.

Orthokeratology is a different, less frequently advised method of using contact lenses to prevent myopia from progressing (also known as Ortho-K). As part of Ortho-K, rigid gas permeable contacts are worn at night to reshape the clear front of the eye (known as the cornea). Myopia can increase after stopping Ortho-K treatment, which is known as the rebound effect.

Any contact lens wear carries a risk of corneal abrasions, ulcers, infections, and scarring that can cause irreversible vision loss.

Greater time spent outside and away from electronics: During the COVID-19 epidemic, there has been growing concern about increased usage of electronics due to remote learning, which could cause myopia to worsen. Studies have indicated that exposure to outdoor natural light can lower the risk of myopia development and progression. Children should strive to spend at least 2 hours outside each day, according to current recommendations.

As always, go over the advantages and disadvantages of these therapeutic choices with your child’s ophthalmologist.